What about flour? If I make my own bread (or dumplings, pancakes, muffins etc) which flours, if any, are low GI?

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Unlock the stairways and step into metabolic fitnessExercise and activity speed up your metabolic rate (increasing the amount of energy you use) which helps you to balance your food intake and control your weight. Exercise and activity also make your muscles more sensitive to insulin and increase the amount of fat you burn. Best of all, the effect of exercise doesn’t end when you stop moving. People who exercise have higher metabolic rates and their bodies burn more kilojoules per minute even when they are asleep!

But you don’t have to run a marathon or join a gym to achieve ‘metabolic fitness’. Seemingly small actions add up to big health benefits that in the long run in conjunction with a low GI diet can reduce your risk of diabetes and heart disease.

It might not feel as if occasionally climbing a flight of stairs instead of taking the lift makes a difference. But it does. A recent study reported in the British Journal of Sports Medicine (2005; 39: 590–593) found that a group of healthy (but sedentary) 19-year-old female office workers who took just two minutes to climb the 199-step stairway in their office building with increasing frequency over an eight week period achieved a 17 per cent increase in aerobic capacity and an 8 per cent decrease in ‘bad’ LDL cholesterol. ‘Such exercise can easily be incorporated into the working day,’ says lead author, Prof Colin Boreham, Professor of Sport and Exercise Science at the University of Ulster, ‘and should be promoted by public health guidelines.’

Don’t despair if the stairways in your office building or apartment block are locked and alarmed and you have to take the lift. ‘Researchers have found that exercise of moderate duration and intensity—including walking—is associated with reduced risk of disease. While brisk walking is best, even slow walkers benefit! Ideally you should accumulate 30 minutes or more on most days of the week. The good news is you can do it in two 15-minute sessions or six 5-minute sessions. It doesn’t matter … To make a real difference to your health and energy, however, physical activity has to be regular and some of it needs to be aerobic. But every little bit counts—and, best of all, any you do that’s more than you are currently doing, is a step in the right direction,’ says Prof Jennie Brand-Miller in Low GI Eating Made Easy.

Tossing and Turning?A small study by Sydney University PhD student, Ahmad Afaghi, reported in The Australian found a high-GI meal eaten four hours before bedtime cut the time needed to get to sleep. Afaghi presented his results at the Australasian Sleep Association Conference in October 2005. He found that the average was nine minutes for people who had eaten a high-GI meal, but 17.5 minutes for those who ate a comparable meal. ‘It makes sense from a physiological point of view,’ says Prof Jennie Brand-Miller. ‘Glucose levels affect the level of trytophan in the blood and therefore serotonin in the brain.’ However, it’s very early days and needs to be confirmed by larger, long-term studies before recommending people with sleep problems start experimenting with high GI meals.

GI and Weight Loss Benefits: Boost or Boast?Researchers from the University of Minnesota set out to test whether reducing the glycemic index of a diet already low in calories would have any further weight loss benefit for obese adults. The small study reported in the Journal of Nutrition confirmed the benefit of lowering glycemic index on insulin sensitivity but not for additional weight loss.

The researchers randomly allocated a group of 29 obese adults to a high GI, low GI or high fat diet (there were about 9 or 10 people in each group). The kilojoule-restricted diet provided ~3000 kJ less than estimated energy needs. The team gave the 29 participants their food for the first 12-week phase and instructions (22 participants at this stage) for the second 24-week, ‘free-living’ part of the trial. At 12 weeks, they found significant weight changes from baseline in all groups, but no difference among groups, with weight loss ranging from 8.4 to 9.9 kg. All groups had improved insulin sensitivity. During the free-living phase, all groups maintained initial weight loss and continued to show improved insulin sensitivity, with both parameters independent of diet composition. The researchers conclude: ‘lowering the glycemic load and glycemic index of weight reduction diets does not provide any added benefit to energy restriction in promoting weight loss in obese subjects.’—Journal of Nutrition, 135:2387-91

GI Group: What about fat loss? The study reports fat mass change (extrapolated from skinfold changes) for the first phase. People on the high GI diet lost 4.5 ± 1.9 kg (mean ± SEM) fat mass over 12 weeks; those on the low GI diet lost 6.9 ± 0.9 kg. If you are wondering why that's not significantly different, it's because they have only 9 or 10 subjects in each group. So the study was underpowered. Had they had more subjects and the difference was similar, it would be significant. To date, eight intervention studies have compared high and low GI diets for weight loss. All favour the low GI diet in one way or another, but in some cases (like the above study), the differences do not reach statistical significance. A meta-analysis can overcome these limitations.

A Little Resistance Goes a Long WaySupplementing foods with resistant starch has the potential to improve insulin sensitivity—a crucial factor in the development of diabetes, report Keith Frayn and his colleagues from the Oxford Centre for Diabetes and INSERM-INRA in France in the September issue of the American Journal of Clinical Nutrition. Over four weeks, they gave ten volunteers 30 grams resistant starch, compared with a placebo. They say ‘Insulin sensitivity was higher after resistant starch supplementation than after placebo treatment,’ making the point that further studies in insulin-resistant people are needed.—American Journal of Clinical Nutrition, 2005; 82 559–567

So, What is Resistant Starch? Most starches are digested and absorbed into the body through the small intestine. Low GI carbs, for example, are digested and absorbed slowly. Some carbs, however, are not absorbed at all. They resist digestion and make their way to the large bowel. Good bacteria in the large bowel ferment the resistant starch and in the process enhance your protection against bowel cancer. This type of starch is called resistant starch. Under-ripe bananas, cold cooked potato, pasta and legumes such as baked beans are all natural sources of resistant starch.

GI? GL? GR? IL? GGE? Getting the MeasureWhere the end-game is about the multiple health benefits of improved insulin management and insulin sensitivity, should we be talking GI (glycemic index), GL (glycemic load), GR (glucose response), II (insulin index), GGE (glycemic glucose equivalents or something else? Azmina Govindji (co-author of The Gi Plan with Nina Puddefoot) explores the most accurate way of describing the glycaemic effect of carbohydrates in the summer 2005 issue of The Nutrition Practitioner. She concludes:

‘From the emerging evidence, it appears that the crucial element is the choice of slowly digested carbohydrates over those that are more rapidly digested. It is about the quality of carbohydrate, not quantity. GI refers to the rate of digestion; it is an intrinsic property of the food, reflecting its quality. GL is analysed from the original GI and reflects the quantity of carbohydrate in particular. Since the key is to choose low glycaemic carbohydrates, a low GL diet may not necessarily offer the glycaemic benefits of a low GI diet. For example, a low GL meal of a normal portion of pasta (a classic low GI food) could have the same GL as a small serving of mashed potato (a high GI food). However, small amounts of mashed potato have not been shown to offer the glycaemic benefits of low glycemic carbohydrate foods.

‘While GI is not a perfect measure and should not be used in isolation, it is currently the most familiar term with UK consumers and the use of an alternative term could cause confusion in the whole glycaemic concept. The science behind the benefits of lower GI is robust and means that this is not a short-term fad. As part of a balanced diet (that is low in sugar and saturates), GI can help consumers make more informed choices.

‘Here is the opportunity for healthcare professionals to fully make use of the media who, lets face it, have more impact on our patients than we could ever hope to achieve. In time, hopefully we will develop the best and most full explanation and terminology. But for now, it makes sense to work with what we have and indeed to take advantage of it. The time has come for us to distinguish between carbohydrates as we currently do for fat. It's about slow carbs, not low carbs. Carbs are fine, but it's the good carbs that really matter.’—The Nutrition Practitioner (Vol 6 Issue 2, summer 2005)

‘Wholegrain’ and Low GI Are Not the SameFor most consumers, ‘wholegrains’ mean eating grains in nature’s packaging—or close to it—traditional rolled oats, cracked wheat, brown rice and pearl barley, for example. There are countless reasons to include more whole cereal grains in your diet, but it’s hard to go past the fact that you are getting all the benefits of their vitamins, minerals, protein, dietary fibre and protective anti-oxidants. Studies around the world show that eating plenty of wholegrain cereals reduces the risk of certain types of cancer, heart disease and type 2 diabetes. A higher fibre intake, especially from whole cereal grains, is linked to a lower risk of cancer of the large bowel, breast, stomach and mouth.

Photo: Scott Dickinson

However, when it comes to what manufacturers can put on the label, there’s no international definition of ‘wholegrain’. It can mean slightly different things in different countries. Food Standards Australia and New Zealand (FSANZ) have expanded the current legal definition for packaging labels to allow more foods including refined wholemeal foods to include ‘wholegrain’ on the label. A manufacturer can now label a food ‘wholegrain’ if ‘the intact grain or the dehulled, ground, milled, cracked or flaked grain, where the constituents—endosperm, germ and bran—are present in such proportions that represent the typical ratio of those fractions occurring in the whole cereal,’ says Lydia Buchtmann, FSANZ Communication Manager.

If you have diabetes or metabolic syndrome and low GI foods are an important part of your diet, what should you do? If there’s no GI rating on the label, follow our rule of thumb, if you can’t see the grains, then don’t assume it’s low GI. Why not follow up and encourage the manufacturers to have their products glycemic index tested?

Porridge PowerFor a high-energy breakfast that sticks to your ribs, warms you up on a crisp day and keeps you firing till lunchtime, it’s hard to go past porridge made with traditional oats—a good source of soluble fibre, B vitamins, vitamin E, iron and zinc. The GI value for porridge has been tested on a number of occasions and the published values range from 42 (for rolled oats made with water) to 82 (for instant oats).

Traditional rolled oats are hulled, steamed and flattened, which makes them a wholegrain cereal. The additional flaking to produce quick cooking or ‘instant’ oats not only speeds up cooking time, it increases the rate of digestion and the GI. This is why traditional rolled oats are preferred over instant in the low GI diet.

Porridge gourmets advocate steel-cut oats—the wholegrains are simply chopped into chunks. These oats may be hard to find but worth the hunt if you like a chewier porridge—and it has a low GI (51).

Follow the instructions on the packet (or use your favourite recipe) to make porridge. A fairly standard rule is one part rolled oats to four parts water. Cooking oats in milk (preferably low fat or skim) not only produces a creamy dish but supplies you with calcium and reduces the overall GI. Don’t skimp on finishing touches for perfect porridge. Choose toppings such as:

Juicy PomegranatesPomegranates are in the news thanks to the current focus on their health giving properties. Recent studies reveal an array of benefits from reducing the risk of heart disease and mediating high blood pressure to reducing the risk of certain cancers including prostate cancer. Jo Rogers in her invaluable resource What Food Is That? says that the pomegranate: ‘has excellent vitamin C, fibre and moderate iron. The pomegranate is slightly higher in kilojoules (calories) than most fruit but contains a wealth of fibre. One pomegranate supplies a quarter of the daily recommended requirement.’

POM Wonderful Pomegranate Juice (GI 67) was glycemic index tested in the US following standardised testing procedures and the results published on www.mendosa.com.

Pomegranates are about the size of a large orange. The leathery skin ranges from dusky pink to brilliant red depending on variety. The multiple chambers inside the fruit are filled with sweet nectar and small arils (seed sacs) bursting with crimson juice. Avoid the white membrane or pith as it is very bitter. Pomegranates are harvested ripe but check before buying as the heavier they are the more juice they will produce. Store them in the fruit bowl for a week or two if the weather is not humid. They can also be refrigerated for a few days. For best results when juicing, cut the fresh fruit in half as you would a grapefruit and use a hand press citrus juicer. If using an electric juicer care should be taken not to include any spongy membrane as the juice will taste tannic and bitter.

Pomegranate molasses is made from boiling the juice of the fruit until it is a thick concentrate, an excellent alternative when pomegranates aren’t in season. It can be purchased from Middle Eastern stores and specialist food shops.

Add pomegranate juice to the blender with low-fat milk, a large banana, some slivered almonds and ice cubes. Add a teaspoon of honey and whiz for 30 seconds for a healthy morning shake.

—Thanks to Australian food writer, restaurant critic and passionate cook, Lynne Mullins, for these meal ideas. Lynne regularly contributes to Good Living and Sunday Life. She is a reviewer for the SMH Good Food Guide and has published two books: Noodles to Pasta, Harper Collins Australia (1999), Relish, New Holland (2001). Lynne presents the fortnightly food and produce segment on Channel Nine ‘Mornings with Kerri-Anne’.

French Green Beans with POM, Goat Cheese & AlmondsThanks to POM Wonderful for this recipe and photograph—a great way to boost your fruit and veggie intake. It was developed and tested using POM Wonderful Pomegranates and 100% Juice. If you enjoy it, check out the POM website for more pomegranate recipes.

1. To free the arils, score 1 fresh pomegranate and place in a bowl of water. Break open the pomegranate underwater—the arils will sink to the bottom of the bowl and the membrane will float to the top. Lift out the membrane then strain putting the arils in a separate bowl. Reserve ⅓ cup of arils and refrigerate or freeze the rest.2. Place oil in a wok or large skillet and heat. Add the beans and stir-fry with the lemon zest for 6 minutes.3. Add the almonds and stir-fry for 1–2 minutes or until beans are crisp-tender. Remove from heat. Season to taste with salt and pepper.4. Toss beans with reserved pomegranate arils and pomegranate juice; turn onto a serving platter.Arrange goat cheese slices over the top and serve.

Sweet Corn LoafChef and ‘Cooking With Conscience’ founder, Michelle Trute, uses Australian Golden Circle canned products in her recipes. As an alternative, purchase the best quality canned corn kernels and creamed corn you can buy for maximum flavour for this sustaining light meal.

1. Combine the corn kernels, creamed corn, onion, garlic, egg whites, yoghurt, cheese, oats and sunflower seeds in a large bowl and mix well.2. Spoon the mixture into the prepared loaf tin and bake for 20 minutes or until cooked—a skewer will come out clean when inserted into the centre of the loaf.3. Serve hot or cold with a crispy salad and vinaigrette dressing and a fresh tomato salsa or sweet tomato relish.

Award winning Executive Chef and international speaker, Michelle Trute, writes weekly for Queensland’s Courier Mail, and presents for ABC radio as well as television on healthy lower GI foods and recipes. Her books, Cooking with Conscience Book 1 and 2, are best sellers and available through her website.

From Kid to Superkid: Set Your Family on the Path to a Junk-Food Free Healthy Futureby Paul Sacher with recipes by Kate McBain (Vermilion)

The advice here is based on Paul Sacher’s own experiences as an extra large lad plus his years of work as a specialist dietitian at Great Ormond Street Hospital for Children (London). Sacher doesn't advocate radical weight loss unless a child is particularly obese. He favours strategies that will keep children at the same weight until their height catches up. 'There's too much emphasis on weight today. What I'm trying to emphasise is raising healthy, happy children. You can be heavy and fit.’ The book is a practical, readable guide for parents and covers:

The benefits of nutrition and diet, weight maintenance and using the GI to help regulate appetite

The importance of making exercise fun along with ideas to help reduce sedentary pasttimes such as watching television or playing on the computer

How to use rewards and goals to encourage positive, healthy behaviour and improve self-esteem and confidence.

FoodwatchFrom fast food to fat loss, you will learn something new about the food and nutrition on Catherine Saxelby’s website: www.foodwatch.com.au–one of the first Australian sites devoted to healthy eating on the internet.

The site has been completely redesigned and a number of new features added so if you haven’t checked it out recently, why not drop by. You can sign up for the free monthly e-newsletter or download articles and fact sheets on how eating the right food will help you improve your vitality, boost your immune system, manage your cholesterol, delay the ageing process, enhance productivity and concentration, normalise your weight and more.

Catherine is a freelance nutritionist and accredited dietitian who is well known for her ability to cut through the clutter of nutrition information and her non-nonsense approach to the modern-day dilemma of healthy eating in a fast paced life. She is the author of seven books including Nutrition for Life, one of the most popular and enduring of nutrition books—the 20th anniversary edition will be published in January 2006 (Hardie Grant Books). She is Nutrition Editor for Australian Table magazine and has written more than 1,000 articles on all aspects of food, fat loss and special diets.

I'm a very keen cook. Here's one burning question for me: what about flour? If I make my own bread (or dumplings, pancakes, muffins etc) which flours, if any, are low GI? There's some implication in the book that chickpea flour (baisen) is low GI. How about soy flour? Wholemeal flour probably isn't any better than white, judging by the results on commercial breads ...

To date there are no GI ratings for refined flour whether it’s made from wheat, soy or other grains. This is because The GI rating of a food must be tested physiologically that is in real people. So far we haven’t had volunteers willing to tuck into 50 gram portions of flour on three occasions! What we do know, however, is that bakery products such as scones, cakes, biscuits, donuts and pastries made from highly refined flour whether it’s white or wholemeal are quickly digested and absorbed.

What should you do with your own baking? Try to increase the soluble fibre content by partially substituting flour with oat bran, rice bran or rolled oats and increase the bulkiness of the product with dried fruit, nuts, muesli, All-Bran or unprocessed bran. Don’t think of it as a challenge. It’s an opportunity for some creative cooking. Here’s how we reduced the overall GI of our baking in The Low GI Diet Cookbook.

To make low GI ‘Buckwheat and Buttermilk Pancakes with Berries’, combine 130 grams (4 1/2 oz) buckwheat flour, 35 grams (1¼ oz) wholemeal flour, 1½ teaspoons baking powder and 2 tablespoons of raw (demerara) sugar in a mixing bowl. Make a well in the centre and pour in 2 lightly beaten eggs, 250 ml (9 fl oz) buttermilk and 1 teaspoon of vanilla essence and whisk until smooth. Add a little more milk if the pancake batter is too thick. Heat a frying pan over medium heat and lightly spray with olive oil. Pour 60 ml (2 fl oz) of the mixture into the pan and cook for 1–2 minutes each side, or until the pancakes are golden and cooked. Repeat with the remaining mixture. Top the pancakes with a spoonful of yoghurt

Photo: Ian Hofstetter, The Low GI Cookbook, Buckwheat Pancakes

And remember, you don’t have to avoid all high GI foods. While you will benefit from eating low GI carbs at each meal, this doesn't have to be at the exclusion of all others.’ So enjoy baking your own bread or occasional treats. And if you combine high GI bakery products with protein foods and low GI carbs such as fruit or legumes, the overall GI value will be medium.